Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2024; 12(20): 4180-4190
Published online Jul 16, 2024. doi: 10.12998/wjcc.v12.i20.4180
Five-blade scratcher for treating severe rhinophyma: A retrospective study
Yu-Ping Zheng, Xu-Feng He, Yan-Feng Zhang, Lan-Xin Geng, Hui-Min Zhang, Hua Wan, Xiang He
Yu-Ping Zheng, Xu-Feng He, Yan-Feng Zhang, Lan-Xin Geng, Hui-Min Zhang, Xiang He, Department of Dermatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Hua Wan, Department of Galactophore, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Co-first authors: Yu-Ping Zheng and Xu-Feng He.
Co-corresponding authors: Hua Wan and Xiang He.
Author contributions: Zheng YP and He XF contributed to this work as co-first authors, especially in data collection, analysis, and drafting of the initial manuscript; Zhang HM conceived the study; Zhang YF and Geng LX helped to revise the manuscript; He X, Wan H were responsible for the idea, funding, and paper revision; He X and Wan H are designated as the co-corresponding authors for the following reasons. The designation of co-corresponding authors on this study accurately reflects the allocation of responsibility and burden associated with the time and effort required to complete the study and final thesis. In addition, He X and Wan H made equally important contributions throughout the entire research process. Choosing them co-corresponding authors is a recognition and respect for their equal contributions, as well as recognition of the teamwork spirit of this study. In summary, we believe that it is appropriate to designate He X and Wan H as co-corresponding authors for our manuscript; all authors contributed to interpret data; all authors have read and approve the final manuscript.
Supported by Shanghai Science and Technology Commission, No. 21ZR1464000.
Institutional review board statement: The study was approved by Institutional Review Board of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine. All the study subjects provided informed consent.
Informed consent statement: The study was approved by Institutional Review Board of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine. All the study subjects provided informed consent.
Conflict-of-interest statement: Dr. He has nothing to disclose.
Data sharing statement: The data in this study can be obtained from the corresponding author upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiang He, MD, Associate Chief Physician, Department of Dermatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, No. 528 Zhangheng Road, Pudong New Area, Shanghai 201203, China. heroxiang2020@126.com
Received: April 22, 2024
Revised: May 21, 2024
Accepted: May 23, 2024
Published online: July 16, 2024
Processing time: 69 Days and 20.7 Hours
Abstract
BACKGROUND

Rhinophyma, a late-stage subtype of rosacea, is characterized by excessive sebaceous glands and connective tissue proliferation. Patients may experience respiratory disturbances and psychological distress that significantly affect their quality of life when excessive nasal hyperplasia obstructs the external nasal valves. Surgery is the treatment of choice for rhinophyma. However, excessive bleeding, scarring, pigmentation, and high recurrence rates frequently characterize current surgical methods.

AIM

To evaluate the clinical effectiveness and recurrence rates after treating severe rhinophyma with the five-blade scratcher.

METHODS

This study retrospectively analyzed the clinical records of 28 patients with severe rhinophyma rosacea. The Global Flushing Severity Score (GFSS), Clinician Erythema Assessment (CEA), Rhinophyma Severity Index (RHISI), Glasgow Benefit Inventory (GBI), and satisfaction scores were used to assess the recovery of patients at 6 months and 5 years, with the recurrence rate calculated at 5 years postoperatively. In addition, the levels of pro-inflammatory factors (TNF-α, IL-1β, and IL-6) in the serum of patients before and after surgery were detected by ELISA.

RESULTS

The GFSS, CEA, and RHISI scores at 6 months and 5 years postoperatively were significantly lower than those preoperatively (P < 0.001 for both periods). Five-blade scratcher treatment greatly benefits patients as demonstrated by the GBI and patient satisfaction. A small number of patients (7/28, 25%) reported recurrence after surgical treatment for rhinophyma in our department that was not more serious than before treatment. The expression of pro-inflammatory factors (TNF-α, IL-1β, and IL-6) in the patient's serum was significantly reduced after surgery of five-blade scratcher.

CONCLUSION

The five-blade scratcher treatment demonstrates notable advantages, including simplicity, safety, efficacy, and cost-effectiveness, coupled with reduced bleeding, minimized scarring, lower recurrence rates, reduced the level of pro-inflammatory factors and improved patient satisfaction. Consequently, this therapeutic modality exhibits a viable option for individuals afflicted with severe rhinophyma.

Keywords: Rhinophyma; Five-blade scratcher; Retrospective study; Efficacy; Recurrence rate

Core Tip: Rhinophyma is known as a late-stage subtype of rosacea. This study aims to observe the clinical effectiveness and recurrence of severe rhinophyma with Xia’s surgical five-blade scratcher treatment. We assessed the Global Flushing Severity Score, Clinician Erythema Assessment, Rhinophyma Severity Index, Glasgow Benefit Inventory, and satisfaction and recurrence of Xia’s surgical five-blade scratcher treatment preoperatively and 6 months and 5 years postoperatively. Five-blade scratcher treatment was safe, effective, and economical, with less bleeding, less scar, low recurrence rates, and high patient satisfaction. It offers an alternative to conventional surgery for severe rhinophyma.